Late February was a busy time for workers' compensation cases from the Georgia Court of Appeals. On February 22, 2007, the Court issued its opinion in Caremore, Inc./Wooddale Nursing Home v. Hollis. This case dealt with what I think is an important issue: O.C.G.A. 34-9-205. I will write separately about the pre-approval problems in workers' compensation cases. This case addressed the employer and insurer's willfulness in failing to comply with the form filing rules under Georgia workers' compensation law. It held that the circumstances warranted a finding of a violation of Board Rule 61.
Another central issue involved the injured worker's meals. The Court held that the meals provided by the employer and insurer increased the average weekly wage, thus entitling the injured worker to additional weekly benefits.
As previously discussed, the issue of pre-authorization creates many problems in workers' compensation cases. My office very often deals with medical providers who, understandably, do not want to perform services without pre-authorization from the workers' compensation insurance company. The problem is that currently pre-authorization is not required for medical services provided by the Authorized Treating Physician or another physician to whom the ATP refers an injured worker. The Form WC-205 is there the rubber meets the road to address this issue. If a Form WC-205 is sent by a medical provider to an employer and insurer, a response is required or the treatment stands pre-approved. In my practice, I make it a point to help medical providers understand the law. Often, we send WC-205's partially completed to the medical provider(s) so all they will have to complete is the pertinent medical information, sign, and send it to the insurer. When insurers drag their feet on getting medical treatment approved, this can be helpful
